PCECN + Family Connects 2025 In-Person Advocacy Day Registration

Accommodations
Do you have any dietary restrictions and/or food allergies?*
Snacks and lunch will be provided. Meals will not be reimbursed.
Will you need Spanish translation/interpretation to participate in Advocacy Day?*

YesNo
Are there any additional accommodations you need to participate in PCECN + FCPC Advocacy Day?

Travel and Coordination

Carpool details will be shared with attendees to coordinate travel.
Parking around the capitol is limited and carpooling is encouraged. Are you able to carpool with other Advocacy Day attendees?

Yes, I can driveYes, I can rideNo, I cannot carpool
As a driver, how many open seats do you have in your car for riders?
Where are you located (for coordination purposes)?
Please enter the city you will be traveling from.
Do you plan to attend Advocacy Day for a full day or a half day?

Full day 8AM to 4PMMorning ONLY 8AM to 12 PMAfternoon ONLY 12 PM to 4 PM
Is there a specific legislator you would like to meet with?
Is there a specific person you want to be grouped with for legislative meetings?
We will do our best to accommodate your requests; Groups will be created according to PCECN or Family Connects affiliation.

Participant Stipends
Participant stipends are available for PCECN and FCPC community participants (parents, child care providers, nurses, etc.) who contribute their expertise, time, experiences, and labor to network activities such as Advocacy Day, and who are not otherwise compensated by First 5 FUNdamentals, an affiliate organization, or employer.

Stipends are available in the following amounts:
- Full day attendees (8 hours) will receive a stipend of $200
- Half day attendees (4 hours) will receive a stipend of $100
Stipends will be provided in the form of a physical Visa Gift Card, presented on Advocacy Day.
Please choose the participant stipend amount that you are requesting:*

$100 for 4 hours$200 for 8 hoursNo Participant Stipend
I acknowledge that I am NOT otherwise being compensated by First 5 FUNdamentals, an affiliate organization, or any employer for my participation in PCECN + FCPC Advocacy Day.*

Yes
Note: Per the IRS, any individual receiving $600 or more in payments in one calendar year (NOT including reimbursements for child care or travel), is required to report this income. In this case, you will be contacted by First 5 Fundamentals and asked to complete a Form W9, and you will receive a Form 1099-NEC for your annual tax return.

Photo/Video Consent for PCECN + Family Connects Advocacy Day

The PCECN and FCPC team will be capturing photos and videos throughout Advocacy Day. Please review the below media consent language and sign accordingly.
First 5 Fundamentals Media Release Form

I give First 5 FUNdamentals, and their supported initiatives including Pierce County Early Childhood Network (PCECN) and Family Connects Pierce County (FCPC), permission and consent to use any images I appear in for marketing and promotional efforts, as well as for advocacy and educational support. This includes, but is not limited to, print media, social media, website, and broadcast.

Photographs, videos, or digital images will not be sold or used for any commercial purposes. If something should arise in which such use is requested, it will be discussed with the subject(s) of the photographs, and a separate written agreement will be made.

I hereby release and discharge First 5 FUNdamentals and their respective initiatives, agents, employees, successors, and licensees from any and all claims, liabilities and obligations of any kind or nature which may arise from my appearance or participation in this activity.
Media Release Consent*

I give consent to PCECN and FCPC to use any images I appear in during 2025 Advocacy Day for marketing and promotional efforts.I DO NOT give consent to PCECN and FCPC to and consent to use any images I appear in for marketing and promotional efforts
Signature*

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2025 Advocacy Day Registration